The University of Southampton
University of Southampton Institutional Repository

Long term methylphenidate exposure and growth in children and adolescents with ADHD. A systematic review and meta-analysis

Long term methylphenidate exposure and growth in children and adolescents with ADHD. A systematic review and meta-analysis
Long term methylphenidate exposure and growth in children and adolescents with ADHD. A systematic review and meta-analysis

BACKGROUND: Methylphenidate (MPH) is an efficacious treatment for ADHD but concerns have been raised about potential adverse effects of extended treatment on growth.

OBJECTIVES: To systematically review the literature, up to December 2018, conducting a meta-analysis of association of long-term (> six months) MPH exposure with height, weight and timing of puberty.

RESULTS: Eighteen studies (ADHD n = 4868) were included in the meta-analysis. MPH was associated with consistent statistically significant pre-post difference for both height (SMD = 0.27, 95% CI 0.16-0.38, p < 0.0001) and weight (SMD = 0.33, 95% CI 0.22-0.44, p < 0.0001) Z scores, with prominent impact on weight during the first 12 months and on height within the first 24-30 months. No significant effects of dose, formulation, age and drug-naïve condition as clinical moderators were found. Data on timing of puberty are currently limited.

CONCLUSIONS: Long-term treatment with MPH can result in reduction in height and weight. However, effect sizes are small with possible minimal clinical impact. Long-term prospective studies may help to clarify the underlying biological drivers and specific mediators and moderators.

Attention deficit/hyperactivity disorder (ADHD), growth, height, methylphenidate, puberty, stimulants, weight
0149-7634
Carucci, Sara
8c5c5ea0-a142-4de4-9298-aa17e3645d9b
Balia, Carla
ee89dee1-00d9-4069-8f42-66fb7e83e4a6
Gagliano, Antonella
b4c62d47-a615-4f11-8700-902d3483c85a
Lampis, Angelico
29790229-408f-49fc-ae33-e296f23a9b15
Buitelaar, Jan K
a2e08a14-4de4-419e-9ea8-1e97ebbdddba
Danckaerts, Marina
e7e7618b-6dd0-4520-bf4e-865597928758
Dittmann, Ralf W
8e6d3484-9cd1-45fe-8d66-d12735860d23
Garas, Peter
81255530-4529-44b7-8361-d6e4f5e4c2e6
Hollis, Chris
fe8adc7a-cfcd-4966-b397-1dd22048bbc8
Inglis, Sarah
4bfba7ae-d941-4949-80f2-83ae5d5df373
Konrad, Kerstin
cf326afb-d9a2-41da-a389-c9ac0a4b8341
Kovshoff, Hanna
82c321ee-d151-40c5-8dde-281af59f2142
Liddle, Elizabeth B
178edbe1-f599-4bf8-8845-5e2be9478bd0
McCarthy, Suzanne
c0549c21-1c94-4084-934c-566aae4d2c4e
Nagy, Peter
1c1ec453-5922-4e81-ad91-759d512472b7
Panei, Pietro
66129eeb-bc6a-4a94-9510-c7af0d44492b
Romaniello, Roberta
800e2168-c494-4737-a312-4946af34329c
Usala, Tatiana
80a4cbce-166f-40d2-a915-1a79f8b7c429
Wong, Ian C K
4212b691-9e14-497f-aac4-e558e205e372
Banaschewski, Tobias
4627c589-04cc-4f5b-ac2d-05f547f63dfd
Sonuga-Barke, Edmund
bc80bf95-6cf9-4c76-a09d-eaaf0b717635
Coghill, David
deea8957-fdfc-488a-a3bb-fb9b536c7172
Zuddas, Alessandro
51df7133-8494-4309-902d-bbf088341e46
Carucci, Sara
8c5c5ea0-a142-4de4-9298-aa17e3645d9b
Balia, Carla
ee89dee1-00d9-4069-8f42-66fb7e83e4a6
Gagliano, Antonella
b4c62d47-a615-4f11-8700-902d3483c85a
Lampis, Angelico
29790229-408f-49fc-ae33-e296f23a9b15
Buitelaar, Jan K
a2e08a14-4de4-419e-9ea8-1e97ebbdddba
Danckaerts, Marina
e7e7618b-6dd0-4520-bf4e-865597928758
Dittmann, Ralf W
8e6d3484-9cd1-45fe-8d66-d12735860d23
Garas, Peter
81255530-4529-44b7-8361-d6e4f5e4c2e6
Hollis, Chris
fe8adc7a-cfcd-4966-b397-1dd22048bbc8
Inglis, Sarah
4bfba7ae-d941-4949-80f2-83ae5d5df373
Konrad, Kerstin
cf326afb-d9a2-41da-a389-c9ac0a4b8341
Kovshoff, Hanna
82c321ee-d151-40c5-8dde-281af59f2142
Liddle, Elizabeth B
178edbe1-f599-4bf8-8845-5e2be9478bd0
McCarthy, Suzanne
c0549c21-1c94-4084-934c-566aae4d2c4e
Nagy, Peter
1c1ec453-5922-4e81-ad91-759d512472b7
Panei, Pietro
66129eeb-bc6a-4a94-9510-c7af0d44492b
Romaniello, Roberta
800e2168-c494-4737-a312-4946af34329c
Usala, Tatiana
80a4cbce-166f-40d2-a915-1a79f8b7c429
Wong, Ian C K
4212b691-9e14-497f-aac4-e558e205e372
Banaschewski, Tobias
4627c589-04cc-4f5b-ac2d-05f547f63dfd
Sonuga-Barke, Edmund
bc80bf95-6cf9-4c76-a09d-eaaf0b717635
Coghill, David
deea8957-fdfc-488a-a3bb-fb9b536c7172
Zuddas, Alessandro
51df7133-8494-4309-902d-bbf088341e46

Carucci, Sara, Balia, Carla, Gagliano, Antonella, Lampis, Angelico, Buitelaar, Jan K, Danckaerts, Marina, Dittmann, Ralf W, Garas, Peter, Hollis, Chris, Inglis, Sarah, Konrad, Kerstin, Kovshoff, Hanna, Liddle, Elizabeth B, McCarthy, Suzanne, Nagy, Peter, Panei, Pietro, Romaniello, Roberta, Usala, Tatiana, Wong, Ian C K, Banaschewski, Tobias, Sonuga-Barke, Edmund, Coghill, David and Zuddas, Alessandro (2020) Long term methylphenidate exposure and growth in children and adolescents with ADHD. A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews. (doi:10.1016/j.neubiorev.2020.09.031).

Record type: Review

Abstract

BACKGROUND: Methylphenidate (MPH) is an efficacious treatment for ADHD but concerns have been raised about potential adverse effects of extended treatment on growth.

OBJECTIVES: To systematically review the literature, up to December 2018, conducting a meta-analysis of association of long-term (> six months) MPH exposure with height, weight and timing of puberty.

RESULTS: Eighteen studies (ADHD n = 4868) were included in the meta-analysis. MPH was associated with consistent statistically significant pre-post difference for both height (SMD = 0.27, 95% CI 0.16-0.38, p < 0.0001) and weight (SMD = 0.33, 95% CI 0.22-0.44, p < 0.0001) Z scores, with prominent impact on weight during the first 12 months and on height within the first 24-30 months. No significant effects of dose, formulation, age and drug-naïve condition as clinical moderators were found. Data on timing of puberty are currently limited.

CONCLUSIONS: Long-term treatment with MPH can result in reduction in height and weight. However, effect sizes are small with possible minimal clinical impact. Long-term prospective studies may help to clarify the underlying biological drivers and specific mediators and moderators.

Text
1-s2.0-S0149763420305923-main - Accepted Manuscript
Download (5MB)

More information

Accepted/In Press date: 27 September 2020
e-pub ahead of print date: 17 October 2020
Additional Information: Funding Information: Prof. Dittmann has received compensation for serving as consultant or speaker, or he or the institution he works for have received research support or royalties from the organizations or companies indicated: EU (FP7 Programme), US National Institute of Mental Health (NIMH), German Federal Ministry of Health/Regulatory Agency (BMG/BfArM), German Federal Ministry of Education and Research (BMBF), German Research Foundation (DFG), Volkswagen Foundation; Boehringer Ingelheim, Ferring, Janssen-Cilag, Lilly, Lundbeck, Otsuka, Servier, Shire, Sunovion/Takeda and Theravance. He owns Eli Lilly stock. Funding Information: Dr. Elizabeth Liddle has had grant support from the Wellcome Trust. Funding Information: Prof. Sonuga-Barke’s financial declarations are: Speaker fees, and conference support from Shire Pharma. Consultancy from Neurotech solutions, Copenhagen University and Berhanderling, Skolerne, KU Leuven. Book royalties from OUP and Jessica Kingsley. Financial support received from Arrhus Univeristy and Ghent University for visiting Professorships. Grants awarded from MRC, ESRC, Wellcome Trust, European Union, NIHR, Nuffield Foundation, Fonds Wetenschappelijk Onderzoek-Vlaanderen (FWO), MQ – Transforming Mental health, The Waterloo Foundation. Editor-in-Chief JCPP – supported by a buy-out of time to Kings College London and personal Honorarium. Non-financial declarations are: Member of the European ADHD Guidelines Group Funding Information: Prof. Ian Wong reports grants from European Union FP7 programme and Hong Kong Research Gran Council during the conduct of the study; grants from Shire, grants from Janssen-Cilag, grants from Eli-Lily, grants from Pfizer, outside the submitted work; and Prof Wong was a member of the National Institute for Health and Clinical Excellence (NICE) ADHD Guideline Group and the British Association for Psychopharmacology ADHD guideline group and acted as an advisor to Shire. Funding Information: The research leading to these results received support from the European Community’s Seventh Framework Programme ( FP7/2007-2013 ) under grant agreement numbers 260576 (ADDUCE). Publisher Copyright: © 2020
Keywords: Attention deficit/hyperactivity disorder (ADHD), growth, height, methylphenidate, puberty, stimulants, weight

Identifiers

Local EPrints ID: 444975
URI: http://eprints.soton.ac.uk/id/eprint/444975
ISSN: 0149-7634
PURE UUID: e7daa6a3-f346-42cd-8d2d-5a7366d6d1ca
ORCID for Hanna Kovshoff: ORCID iD orcid.org/0000-0001-6041-0376

Catalogue record

Date deposited: 13 Nov 2020 17:33
Last modified: 23 Nov 2022 05:01

Export record

Altmetrics

Contributors

Author: Sara Carucci
Author: Carla Balia
Author: Antonella Gagliano
Author: Angelico Lampis
Author: Jan K Buitelaar
Author: Marina Danckaerts
Author: Ralf W Dittmann
Author: Peter Garas
Author: Chris Hollis
Author: Sarah Inglis
Author: Kerstin Konrad
Author: Hanna Kovshoff ORCID iD
Author: Elizabeth B Liddle
Author: Suzanne McCarthy
Author: Peter Nagy
Author: Pietro Panei
Author: Roberta Romaniello
Author: Tatiana Usala
Author: Ian C K Wong
Author: Tobias Banaschewski
Author: Edmund Sonuga-Barke
Author: David Coghill
Author: Alessandro Zuddas

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×